EP2647354B1 - Dispositif de support pour des prothèses de valvules cardiaques - Google Patents

Dispositif de support pour des prothèses de valvules cardiaques Download PDF

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Publication number
EP2647354B1
EP2647354B1 EP12425070.5A EP12425070A EP2647354B1 EP 2647354 B1 EP2647354 B1 EP 2647354B1 EP 12425070 A EP12425070 A EP 12425070A EP 2647354 B1 EP2647354 B1 EP 2647354B1
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EP
European Patent Office
Prior art keywords
support device
support
formations
tubular element
shaft
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EP12425070.5A
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German (de)
English (en)
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EP2647354A1 (fr
Inventor
Andrea Marchisio
Giovanni Rolando
Paolo Gaschino
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Sorin Group Italia SRL
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Sorin Group Italia SRL
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Publication date
Application filed by Sorin Group Italia SRL filed Critical Sorin Group Italia SRL
Priority to EP12425070.5A priority Critical patent/EP2647354B1/fr
Priority to ES12425070.5T priority patent/ES2552382T3/es
Priority to PCT/IB2013/052080 priority patent/WO2013150403A1/fr
Priority to US13/835,593 priority patent/US9358105B2/en
Publication of EP2647354A1 publication Critical patent/EP2647354A1/fr
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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2427—Devices for manipulating or deploying heart valves during implantation

Definitions

  • the disclosure relates to valve prostheses and in particular to support devices therefor.
  • a support device according to the preamble of Claim 1 is disclosed in pending European Patent application n. 11166742.4 (published as EP-A-2 387 972 ) in the name of the same Applicant.
  • cardiac valve prostheses can essentially be divided into two basic categories, namely:
  • the biological valve leaflet material which is subject to treatment (stabilization) to render it biologically inert, can be derived from a natural cardiac valve taken from an animal (for example a pig) or can be formed from biological tissue other than valve tissue (for example, bovine pericardium).
  • Biological valve prostheses may in turn take the form of "stented" valves - where the valve leaflets are mounted on a rigid or slightly flexible stent or armature - and “unstinted", or “stentless”, valves.
  • EP-A-0 515 324 and US 5,713,953 disclose various embodiments of stentless cardiac valve prostheses, including embodiments where the biological material is replaced (either partially or completely) with an artificial/synthetic material such as a micro-porous and/or composite synthetic material, for example polyurethane.
  • an artificial/synthetic material such as a micro-porous and/or composite synthetic material, for example polyurethane.
  • Stentless valve prostheses exhibit as a whole characteristics of deformability that offer functional advantages due to a great similarity to the anatomy of natural valves. In fact, compared to mechanical valves, stentless valve prostheses allow to obtain a physiological transvalvular flow and do not require anticoagulation therapy. Additionally, such a prostheses also exhibit a superior hemodynamic performance compared to biological stented valves having the same diameter.
  • the implantation of a stentless valve prosthesis may involve positioning the prostheses at the implantation site (e.g. an aortic site) by using a holder device.
  • the implantation site e.g. an aortic site
  • the holder may, for example, support the prostheses:
  • Holder devices may include a support or "grip" hub adapted for connection to a manipulation handle.
  • the surgeon can thus locate a prostheses (fixedly held by the holder) at the implantation site and properly orient it to ensure that the leaflets of the prosthesis are positioned at the same angular locations of the leaflets of the natural valve substituted by the prostheses.
  • Exemplary of such a holder is the arrangement disclosed in US 2008/0262603 A1 , including a grip element from which a plurality of arms extend for supporting a prosthetic heart valve at an intermediate position between the commissures.
  • a support device for stentless heart valve prostheses including:- a shaft defining a manipulation axis, - a plurality of support formations for a stentless valve prostheses, - a connection portion flexibly connecting the shaft and the support formations to permit a displacement of the manipulation axis with respect to the support formations, wherein the connection portion consists of a helical track cut in a tubular element and wherein the shaft, the plurality of support formations and the connection portion are formed in a single piece from the tubular element.
  • - figure 1 is a perspective view of a support device for stentless heart valve prostheses according to various exemplary embodiments
  • - figure 2 is a perspective view corresponding to that of figure 1 but showing various deformed conditions
  • - figure 3 is a perspective view of a support device according to various embodiments coupled to a biological stentless heart valve prosthesis and shown in one possible deformed condition
  • - figure 4 is a perspective view of a support device according to various embodiments coupled to a biological stentless heart valve prosthesis and shown in another possible deformed condition
  • the reference number 1 in figure 1 identifies as a whole a supporting device for stentless heart valve prostheses according to various exemplary embodiments.
  • a supporting device 1 includes a shaft 2 defining a manipulation axis X1, a plurality of support formations 4 intended for supporting a stentless heart valve prostheses and a connection portion 6 flexibly connecting the shaft 2 and the supporting formations 4, which in turn depart form a hub 7 immediately adjacent to the connection portion 6. All the components mentioned above are formed in a single piece from a tubular element T which is subject to a number of cutting and forming operations. In various embodiments the tubular element T has a circular cross section.
  • a distal portion 8 of the tubular element T there are provided the shaft 2 and the connection portions 6 by means of a helical track 10 cut into the tubular member T.
  • the hub 7 and a plurality of radial holes located thereon and which in one embodiment may be arranged in pairs oriented along the direction of the manipulation axis X1, are provided. Furthermore adjacent pairs of radial holes 12 may be axially staggered.
  • distal and proximal are used with reference, so to say, to the implantation site, i.e. proximal being a location close to the implantation site (and corresponding to that of a valve prosthesis coupled to the support device 1) while distal being a location away from the implantation site.
  • coupling formations 14, 16 which may be in the form of longitudinal slits 14 or in the form of radial holes 16 or both.
  • Such coupling formations are intended to provide a connection, e.g. of the snap-fit type, of the support device 1 to a manipulation tool which will be described in the following.
  • no such formations 14 and 16 are present, so that the coupling between the manipulation tool and the support device may be achieved by relying upon an interference fit.
  • each supporting formation is shaped as a supporting arm including a first portion 18 extending radially away from the manipulation axis X1 and a second portion 20, which is bent with respect to the first portion 18 and which extends substantially parallel to the manipulation axis X1.
  • the first portions 18 may be formed so to extend also axially away from the shaft 2.
  • each supporting formation 4 may include a first eyelet 22 located at a position corresponding to that of the bend between the first portion 18 and the second portion 20 and a second eyelet 24 located at a free end of the second portion 20.
  • each supporting arm 4 may include only one eyelet, either being the eyelet 22 or 24.
  • the eyelets 22,24 may be oriented so that respective axes Y22, Y24 thereof are incident to the manipulation axis X1.
  • each of the supporting arms 4 which, in the embodiment depicted in the number of three and with even angular spacing (i.e. 120 degrees) around the manipulation axis X1, are capable of flexing inwards and outwards in a radial direction.
  • Figure 2 in particular shows in phantom line two possible deformed conditions of each of the supporting arms 4.
  • each supporting arm 4 may be mainly concentrated on the second portion 20 thereof, whilst the first portions 18 may be designed with a greater bending stiffness in order to provide a sufficient support action to a valve prostheses which is coupled to the device 1.
  • the portions 18 may be shaped so to have a U-shaped cross section which offers a higher bending moment of inertia.
  • connection portion 6 as a stretch of the tubular element T whereat the helical track 10 is cut allows a displacement of the manipulation axis X1 with respect to the supporting formations 4, wherein such displacement may be obtained by manipulating the shaft 2 itself.
  • the helical track 10 breaks the structural continuity of the tubular element T at an intermediate position between the shaft 2 and the hub 7 wherefrom the supporting arms 4 depart.
  • This may be regarded as substantially equivalent, so to say, to provide a leaf, helically wound, spring connecting the shaft 2 and the hub 7 and being capable of providing an effect which resembles that of a universal joint.
  • a displacement of the manipulation axis X1 may be achieved by the deformation of the connection portion 6, wherein various "turns" of the spring-like element defined by the cutting of the helical track 10 are able to separate axially thereby allowing a departure from the rectilinear shape of the proximal portion 8.
  • the supporting device 1 is shown coupled to an exemplary stentless heart valve prosthesis.
  • the stentless heart valve prosthesis is indicated by the reference V and includes, in one embodiment, three coapting valve leaflets VL defining three corresponding commissures C whereat the supporting arms 4 of the device 1, in particular the portions 20 thereof, are located.
  • the portions 20 are arranged within the orifice defined by the valve V, particularly inside the commissures C at a position substantially comprised between two adjacent leaflets VL.
  • the number of the supporting formations 4 may be chosen so as to be equal to the number of the commissures C of the valve V which is to be coupled to the support device 1.
  • valve prostheses V may be temporarily attached to the arms 4 by means of suture threads S piercing the commissures C and routed through corresponding eyelets 22, 24.
  • Each suture thread may then be passed through the holes 12 (or, more generally, may be routed through the hub 7) in order to provide a safe anchoring of the valve prosthesis V to the support device 1.
  • At least one through hole 120 - and preferably more than one - may be formed on the portion 18 of each of the supporting arms 4, so that the suture threads S may be routed therethrough.
  • each of the supporting arms 4 allows for a multiple displacement within the support device 1. More to the point, in addition to the displacement of the shaft 2 with respect to the supporting formations 4, that is the displacement of the manipulation axis X1 by an angle ⁇ 1 with respect to its non-displaced position, an additional displacement may be achieved between the manipulation axis X1 and a main axis XV of the valve prostheses V.
  • the manipulation axis is identified by the reference X1 in its non-displaced position and by the reference X1' in its displaced position.
  • an angle ⁇ 2 by which the axis XV may be inclined with respect to the manipulation axis X1 may be the result of the bending of each of the supporting arms 4, in particular of the portions 20.
  • a manipulation tool 100 may be coupled to the support device 1.
  • the manipulation tool 100 may comprise, in various embodiments, a handle 102 which may be designed with an ergonomical shape, and a rod 104 which is sized and dimensioned in order to fit into the shaft 2 and engage in corresponding ones of the connection formations 14,16.
  • the rod 104 is sized and dimensioned so to provide an interference with the tubular element T, so that a coupling by means of an interference fit between the rod 104 and the support device 1 (in particular the shaft 2) can be achieved.
  • the practitioner may thus vary the position of the manipulation axis X1 with respect to its nominal (i.e. non-displaced) position and also achieve a displacement of the valve axis XV with respect to the axis X1 depending on the specific needs during the intervention.
  • the practitioner may also displace the support device 1 with respect to the valve V in order to better perform, for example, stitching operations in correspondence of a specific region of the valve V.
  • the practitioner may then cut the suture threads S and separate the support device 1 from the prosthesis V by gently pulling the device 1 axially away therefrom.
  • connection portion 6 may be provided as a weakened stretch on the tubular element T defined by a plurality of axial slits resulting in the shaft 2 and the hub 7 being connected by a plurality of bridging elements capable of buckling inwards (and outwards) towards the axis X1 in order to provide the desired degree of deformation.
  • each pair of holes 12 may be replaced by a single hole, or in alternative, a hook obtained by cutting the corresponding, unfolded shape thereof into the tubular element T and then bending the cut shape outwards of the tubular element T or, as a further alternative, by C-shaped openings.
  • the material of the tubular element be a shape memory material such as a super elastic alloy.
  • a shape memory material such as a super elastic alloy.
  • Nitinol is a preferred option.
  • the support device 1 may be cut by using the same techniques as those used for cutting stents, i.e. the various components of the support device 1 may be cut into the tubular element T by means of laser beams.
  • the structure itself of the support device 1 may be subjected to a large number of modifications and various other structures, shapes, patterns may be conferred to each of the components thereof (including the connection portion 6, the shaft 2, the hub 7 and the supporting formations 4) by varying the cutting path of the laser beam which are used to cut the tube T.
  • connection portion herein indicated as 6'
  • the connection portion may be provided as an apertured structure, possibly - so to say - a stent-like structure including a plurality of apertures 10' cut into the shaft 2.
  • the apertures may have rectangular shape and may be arranged in radially offset bands.
  • connection portion may moreover be provided in combination with either arrangement of the holes 12 and/or 120 described above, that is, one may have embodiments wherein the connection portion 6 is provided as an apertured structure and wherein only the holes 12 are present or wherein only the holes 120 are present or furthermore wherein both the holes 12 and 120 are present.
  • Embodiment 1 a support device for stentless heart valve prostheses including: - a shaft defining a manipulation axis, - a plurality of support formations for a stentless valve prosthesis, and - a connection portion flexibly connecting the shaft and the support formations to permit a displacement of the manipulation axis with respect to the support formations, wherein said connection portion consist of a helical track cut in a tubular element and wherein the shaft, the plurality of support formations and the connection portion are formed in a single piece from the tubular element.
  • Embodiment 2 the support device of embodiment 1, wherein the tubular element is made of a shape memory material.
  • Embodiment 3 the support device of either embodiment 1 or 2, wherein the tubular element is made of nitinol.
  • Embodiment 4 the support device (1) of any of the previous embodiments, wherein said plurality of support formations includes support arms which are cut in said tubular element and shaped so that they protrude there from, said support arms departing from a hub provided on said tubular element adjacent to said connection portion.
  • Embodiment 5 the support device of embodiment 4, wherein said support arms include a first portion (18) extending radially away from said manipulation axis and a second portion , bent with respect to said first portion, which extends substantially parallel to said manipulation axis.
  • Embodiment 6 the support device of embodiment 5, wherein the first portion of each support arm also extends in an axial direction of the support device.
  • Embodiment 7 the support device of any of embodiments 4 to 6, including three support arms arranged with an even angular spacing around said manipulation axis.
  • Embodiment 8 the support device of any of the previous claims, wherein the shaft comprises a free end at which connection formations configured for coupling the support device to a manipulation tool are provided.
  • Embodiment 9 the support device of any of embodiments 4 to 7, further including at least one through hole provided on said tubular member at a radial position corresponding to that of a supporting formation associated thereto.
  • Embodiment 10 the support device of embodiment 10, wherein said at least one through hole is provided on said hub.
  • Embodiment 11 the support device of embodiment 5, wherein each support arm includes a first eyelet located at a position between said first and second portions and a second eyelet at a free end of said second portion.
  • Embodiment 12 the support device of Embodiment 5 or Embodiment 10, further comprising at least one through hole located on the first portion of each supporting arm.
  • Embodiment 13 a combination of a stentless heart valve prosthesis and a support device according to any of embodiments 1 to 13.
  • Embodiment 14 the combination of embodiment 13, wherein said stentless heart valve prosthesis is an aortic valve prostheses including three coapting valve leaflets and three commissures, each coupled to a corresponding support formation.

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  • Health & Medical Sciences (AREA)
  • Cardiology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Transplantation (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Claims (14)

  1. Dispositif de support (1) pour des prothèses de valvule cardiaque sans endoprothèse vasculaire (V) comportant :
    - une tige (2) définissant un axe de manipulation (X1, X1'),
    - une pluralité de formations de support (4) pour une prothèse de valvule sans endoprothèse vasculaire (4), et
    - une partie de raccordement (6 ; 6') reliant de manière flexible la tige (2) et les formations de support (4) pour permettre un déplacement de l'axe de manipulation (X1, X1') par rapport aux formations de support (4),
    dans lequel la tige (2), la pluralité de formations de support (4) et la partie de raccordement (6 ; 6') sont formées en une seule pièce à partir d'un élément tubulaire (T),
    le dispositif de support (1) étant caractérisé en ce que ladite partie de raccordement (6) est constituée d'une piste hélicoïdale (10) découpée dans ledit élément tubulaire (T).
  2. Dispositif de support (1) de la revendication 1, dans lequel l'élément tubulaire (T) est réalisé en un matériau à mémoire de forme.
  3. Dispositif de support (1) de la revendication 1 ou 2, dans lequel l'élément tubulaire (T) est réalisé en nitinol.
  4. Dispositif de support (1) de l'une des revendications précédentes, dans lequel ladite pluralité de formations de support comporte des bras de support (4) qui sont découpés dans ledit élément tubulaire (T) et conformés de sorte qu'ils fassent saillie à partir de celui-ci, lesdits bras de support partant d'un moyeu (7) prévu sur ledit élément tubulaire (T) adjacent à ladite partie de raccordement (6 ; 6').
  5. Dispositif de support (1) de la revendication 4, dans lequel lesdits bras de support (4) comportent une première partie (18) s'étendant radialement loin dudit axe de manipulation (X1) et une deuxième partie (20), pliée par rapport à ladite première partie (18), qui s'étend essentiellement parallèlement audit axe de manipulation (X1).
  6. Dispositif de support (1) de la revendication 5, dans lequel la première partie (18) de chaque bras de support (4) s'étend également dans une direction axiale (X1) du dispositif de support (1).
  7. Dispositif de support (1) de l'une des revendications 4 à 6, comportant trois bras de support (4) agencés avec un espacement angulaire régulier autour dudit axe de manipulation (X1).
  8. Dispositif de support (1) de l'une des revendications précédentes, dans lequel la tige (2) comprend une extrémité libre au niveau de laquelle des formations de raccordement (14, 16) configurées pour coupler le dispositif de support (1) à un outil de manipulation (100) sont prévues.
  9. Dispositif de support (1) de l'une des revendications 4 à 7, comportant en outre au moins un trou traversant (12) prévu sur ledit élément tubulaire (T) à une position radiale correspondant à celle d'une formation de support qui lui est associée.
  10. Dispositif de support (1) de la revendication 9, dans lequel ledit au moins un trou traversant (12) est prévu sur ledit moyeu (7).
  11. Dispositif de support (1) de la revendication 5, dans lequel chaque bras de support (4) comporte un premier oeillet (22) situé à une position entre lesdites première et deuxième parties (18, 20) et un deuxième oeillet (24) au niveau d'une extrémité libre de ladite deuxième partie (24).
  12. Dispositif de support (1) de la revendication 5 ou 9, comprenant en outre au moins un trou traversant (120) situé sur la première partie (18) de chaque bras de support (4).
  13. Combinaison d'une prothèse de valvule cardiaque sans endoprothèse vasculaire (V) et d'un dispositif de support (1) selon l'une des revendications 1 à 12.
  14. Combinaison de la revendication 13, dans laquelle ladite prothèse de valvule cardiaque sans endoprothèse vasculaire (V) est une prothèse de valvule aortique comportant trois feuillets valvulaires de coaptation (VL) et trois commissures (C), chacun(e) étant couplé(e) à une formation de support correspondante (4).
EP12425070.5A 2012-04-04 2012-04-04 Dispositif de support pour des prothèses de valvules cardiaques Active EP2647354B1 (fr)

Priority Applications (4)

Application Number Priority Date Filing Date Title
EP12425070.5A EP2647354B1 (fr) 2012-04-04 2012-04-04 Dispositif de support pour des prothèses de valvules cardiaques
ES12425070.5T ES2552382T3 (es) 2012-04-04 2012-04-04 Dispositivo de soporte para prótesis de válvulas cardíacas
PCT/IB2013/052080 WO2013150403A1 (fr) 2012-04-04 2013-03-15 Dispositif de support pour prothèses de valvule cardiaque
US13/835,593 US9358105B2 (en) 2012-04-04 2013-03-15 Support device for heart valve prostheses

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
EP12425070.5A EP2647354B1 (fr) 2012-04-04 2012-04-04 Dispositif de support pour des prothèses de valvules cardiaques

Publications (2)

Publication Number Publication Date
EP2647354A1 EP2647354A1 (fr) 2013-10-09
EP2647354B1 true EP2647354B1 (fr) 2015-10-07

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EP12425070.5A Active EP2647354B1 (fr) 2012-04-04 2012-04-04 Dispositif de support pour des prothèses de valvules cardiaques

Country Status (4)

Country Link
US (1) US9358105B2 (fr)
EP (1) EP2647354B1 (fr)
ES (1) ES2552382T3 (fr)
WO (1) WO2013150403A1 (fr)

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US10940001B2 (en) 2012-05-30 2021-03-09 Neovasc Tiara Inc. Methods and apparatus for loading a prosthesis onto a delivery system
US11311376B2 (en) 2019-06-20 2022-04-26 Neovase Tiara Inc. Low profile prosthetic mitral valve
US11357622B2 (en) 2016-01-29 2022-06-14 Neovase Tiara Inc. Prosthetic valve for avoiding obstruction of outflow
US11389291B2 (en) 2013-04-04 2022-07-19 Neovase Tiara Inc. Methods and apparatus for delivering a prosthetic valve to a beating heart
US11413139B2 (en) 2011-11-23 2022-08-16 Neovasc Tiara Inc. Sequentially deployed transcatheter mitral valve prosthesis
US11419720B2 (en) 2010-05-05 2022-08-23 Neovasc Tiara Inc. Transcatheter mitral valve prosthesis
US11464631B2 (en) 2016-11-21 2022-10-11 Neovasc Tiara Inc. Methods and systems for rapid retraction of a transcatheter heart valve delivery system
US11491006B2 (en) 2019-04-10 2022-11-08 Neovasc Tiara Inc. Prosthetic valve with natural blood flow
US11497602B2 (en) 2012-02-14 2022-11-15 Neovasc Tiara Inc. Methods and apparatus for engaging a valve prosthesis with tissue
US11602429B2 (en) 2019-04-01 2023-03-14 Neovasc Tiara Inc. Controllably deployable prosthetic valve
US11737872B2 (en) 2018-11-08 2023-08-29 Neovasc Tiara Inc. Ventricular deployment of a transcatheter mitral valve prosthesis
US11779742B2 (en) 2019-05-20 2023-10-10 Neovasc Tiara Inc. Introducer with hemostasis mechanism
US11793640B2 (en) 2017-08-25 2023-10-24 Neovasc Tiara Inc. Sequentially deployed transcatheter mitral valve prosthesis
US11998447B2 (en) 2019-03-08 2024-06-04 Neovasc Tiara Inc. Retrievable prosthesis delivery system

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US9730790B2 (en) 2009-09-29 2017-08-15 Edwards Lifesciences Cardiaq Llc Replacement valve and method
CN103997990A (zh) 2011-06-21 2014-08-20 托尔福公司 人工心脏瓣膜装置及相关系统和方法
JP6133309B2 (ja) 2011-10-19 2017-05-24 トゥエルヴ， インコーポレイテッド 人工心臓弁デバイス
US11202704B2 (en) 2011-10-19 2021-12-21 Twelve, Inc. Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods
JP6151705B2 (ja) 2011-10-19 2017-06-21 トゥエルヴ， インコーポレイテッド 心臓弁置換のためのデバイス、システムおよび方法
US9039757B2 (en) 2011-10-19 2015-05-26 Twelve, Inc. Prosthetic heart valve devices, prosthetic mitral valves and associated systems and methods
US9681951B2 (en) 2013-03-14 2017-06-20 Edwards Lifesciences Cardiaq Llc Prosthesis with outer skirt and anchors
US10702378B2 (en) 2017-04-18 2020-07-07 Twelve, Inc. Prosthetic heart valve device and associated systems and methods
US10709591B2 (en) 2017-06-06 2020-07-14 Twelve, Inc. Crimping device and method for loading stents and prosthetic heart valves
US10729541B2 (en) 2017-07-06 2020-08-04 Twelve, Inc. Prosthetic heart valve devices and associated systems and methods
US10786352B2 (en) 2017-07-06 2020-09-29 Twelve, Inc. Prosthetic heart valve devices and associated systems and methods
US11452599B2 (en) 2019-05-02 2022-09-27 Twelve, Inc. Fluid diversion devices for hydraulic delivery systems and associated methods

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US11419720B2 (en) 2010-05-05 2022-08-23 Neovasc Tiara Inc. Transcatheter mitral valve prosthesis
US12053369B2 (en) 2011-11-23 2024-08-06 Neovasc Tiara Inc. Sequentially deployed transcatheter mitral valve prosthesis
US11413139B2 (en) 2011-11-23 2022-08-16 Neovasc Tiara Inc. Sequentially deployed transcatheter mitral valve prosthesis
US11497602B2 (en) 2012-02-14 2022-11-15 Neovasc Tiara Inc. Methods and apparatus for engaging a valve prosthesis with tissue
US11617650B2 (en) 2012-05-30 2023-04-04 Neovasc Tiara Inc. Methods and apparatus for loading a prosthesis onto a delivery system
US11389294B2 (en) 2012-05-30 2022-07-19 Neovasc Tiara Inc. Methods and apparatus for loading a prosthesis onto a delivery system
US10940001B2 (en) 2012-05-30 2021-03-09 Neovasc Tiara Inc. Methods and apparatus for loading a prosthesis onto a delivery system
US11389291B2 (en) 2013-04-04 2022-07-19 Neovase Tiara Inc. Methods and apparatus for delivering a prosthetic valve to a beating heart
US11357622B2 (en) 2016-01-29 2022-06-14 Neovase Tiara Inc. Prosthetic valve for avoiding obstruction of outflow
US11464631B2 (en) 2016-11-21 2022-10-11 Neovasc Tiara Inc. Methods and systems for rapid retraction of a transcatheter heart valve delivery system
US11793640B2 (en) 2017-08-25 2023-10-24 Neovasc Tiara Inc. Sequentially deployed transcatheter mitral valve prosthesis
US11737872B2 (en) 2018-11-08 2023-08-29 Neovasc Tiara Inc. Ventricular deployment of a transcatheter mitral valve prosthesis
US11998447B2 (en) 2019-03-08 2024-06-04 Neovasc Tiara Inc. Retrievable prosthesis delivery system
US11602429B2 (en) 2019-04-01 2023-03-14 Neovasc Tiara Inc. Controllably deployable prosthetic valve
US11491006B2 (en) 2019-04-10 2022-11-08 Neovasc Tiara Inc. Prosthetic valve with natural blood flow
US12036117B2 (en) 2019-04-10 2024-07-16 Neovasc Tiara Inc. Prosthetic valve with natural blood flow
US11779742B2 (en) 2019-05-20 2023-10-10 Neovasc Tiara Inc. Introducer with hemostasis mechanism
US11931254B2 (en) 2019-06-20 2024-03-19 Neovasc Tiara Inc. Low profile prosthetic mitral valve
US11311376B2 (en) 2019-06-20 2022-04-26 Neovase Tiara Inc. Low profile prosthetic mitral valve

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US20130268068A1 (en) 2013-10-10
WO2013150403A1 (fr) 2013-10-10
US9358105B2 (en) 2016-06-07
EP2647354A1 (fr) 2013-10-09

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